Effects of Interventions for Menstrual Health and Hygiene Management for Adolescent Girls: A Systematic Review and Meta-analysis

Authors

  • Hitomi Hamada Master of Nursing, Graduate School of Nursing Science, St Luke’s International University, Tokyo, Japan.
  • Mika Ninohei Daito Bunka University, Faculty of Sports and Health Science, Public Health Nursing, Japan.
  • Noyuri Yamaji The University of Tokyo, Japan.
  • Erika Ota St Luke’s International University, Tokyo, Japan.

DOI:

https://doi.org/10.60099/prijnr.2024.265202

Keywords:

Adolescents, Female, Feminine hygiene products, Health behavior, Health knowledge, Attitudes, Practice, Menstruation, Systematic review

Abstract

Menstruation relates to women’s well-being, and menstrual health and hygiene are important. However, the effects of menstrual health and hygiene interventions remain unclear. This systematic review assessed the effects of menstrual health and hygiene interventions on adolescent girls and young women. Structured systematic searches were conducted using five databases from 5 August to 30 September 2022 with no restriction. We included individual-, cluster- and quasi-randomized controlled trials that assessed
the effects of menstrual health and hygiene interventions on the quality of life and social outcomes. Two researchers independently completed the screening process and assessed the risk of bias using the second version of the Cochrane risk of bias tool for randomized trials.
Ten studies were described in 12 reports, and three ongoing studies were included. Five studies evaluated education interventions, one evaluated the distribution of menstrual products, and four assessed both. No study reported the quality of life. A small but non-significant positive impact on school attendance was found from the meta-analysis of four studies evaluating the distribution of sanitary products compared with no intervention (SMD = 0.23, 95%CI [-0.03, 0.48]). Although this study’s result should be used cautiously, menstrual health and hygiene interventions offer positive outcomes. Quality of life should be assessed as well. More
comprehensive and innovative interventions and a rigorous research design are required, and nurses have an important role in education, practice and further research on this topic.

References

United Nations Children’s Fund. Guidance on menstrual health and hygiene [Internet]. 2019 Mar [cited 2021 Oct 31]. Available from: https://www.unicef.org/media/91341/file/UNICEF-Guidance-menstrual-health-hygiene-2019.pdf

National Institute for Health and Care Excellence. Heavy menstrual bleeding: assessment and management [Internet]. 2021 May 24 [cited 2021 Mar 23]. Available from: https://www.nice.org.uk/guidance/ng88

American Medical Women’s Association. Period poverty [Internet]. 2019 Oct 31[cited 2023 Dec 8]. Available from: https://www.amwa-doc.org/period-poverty/.

Chinyama J, Chipungu J, Rudd C, Mwale M, Verstraete L, Sikamo C, et al. Menstrual hygiene management in rural schools of Zambia: a descriptive study of knowledge, experiences and challenges faced by schoolgirls. BMC Public Health. 2019 Jan 5;19(1):16. doi: 10.1186/s12889-018-6360-2. DOI: https://doi.org/10.1186/s12889-018-6360-2

Ha MAT, Alam MZ. Menstrual hygiene management practice among adolescent girls: an urban-rural comparative study in Rajshahi division, Bangladesh. BMC Womens Health. 2022 Mar 23;22(1):86. doi: 10.1186/s12905-022-01665-6. DOI: https://doi.org/10.1186/s12905-022-01665-6

Asumah MN, Abubakari A, Gariba A. Schools preparedness for menstrual hygiene management: a descriptive cross-sectional study in the west Gonja municipality, Savannah region of Ghana. BMJ Open. 2022 Apr 1;12(4): e056526. doi: 10.1136/bmjopen-2021-056526. DOI: https://doi.org/10.1136/bmjopen-2021-056526

Sahiledengle B, Atlaw D, Kumie A, Tekalegn Y, Woldeyohannes D, Agho KE. Menstrual hygiene practice among adolescent girls in Ethiopia: a systematic review and meta-analysis. PLoS One. 2022 Jan 4;17(1): e0262295. doi: 10.1371/journal.pone.0262295. DOI: https://doi.org/10.1371/journal.pone.0262295

Ministry of Health, Labour and Welfare. Survey on the effects of “period poverty” on women’s mental and physical health [Internet]. 2022 Mar 23 [cited 2022 Mar 23]. Available from: https://www.mhlw.go.jp/content/10904750/000917682.pdf

Cardoso LF, Scolese AM, Hamidaddin A, Gupta J. Period poverty and mental health implications among college-aged women in the United States. BMC Womens Health. 2021 Jan 6;21(1):14. doi: 10.1186/s12905-020-01149-5. DOI: https://doi.org/10.1186/s12905-020-01149-5

World Health Organization, United Nations Children’s Fund. Consultation on draft long list of goal, target and indicator options for future global monitoring of water WHO and UNICEF 2012 [Internet]. 2012 Aug [cited 2021 Mar 23]. Available from: https://washdata.org/reports/consultation-goal-target-and-indicator-options-future-global-monitoring-water-sanitation

United Nations Educational, Scientific and Cultural Organization. Puberty education & menstrual hygiene management [Internet]. 2014 [cited 2021 Mar 23]. Available from: https://unesdoc.unesco.org/ark:/48223/pf0000226792

Shah SP, Nair R, Shah PP, Modi DK, Desai SA, Desai L. Improving the quality of life with new menstrual hygiene practices among adolescent tribal girls in rural Gujarat, India. Reprod Health Matters. 2013 May;21(41): 205- 13. doi: 10.1016/S0968-8080(13)41691-9. DOI: https://doi.org/10.1016/S0968-8080(13)41691-9

Hennegan J, Montgomery P. Do menstrual hygiene management interventions improve education and psychosocial outcomes for women and girls in low and middle income countries? A systematic review. PLoS One. 2016 Feb 10;11(2):e0146985. doi: 10.1371/journal.pone.0146985. DOI: https://doi.org/10.1371/journal.pone.0146985

Sahoo KC, Negi S, Patel K, Mishra BK, Palo SK, Pati S. Challenges in maternal and child health services delivery and access during pandemics or public health disasters in low-and middle-income countries: a systematic review. Healthcare (Basel). 2021 Jun 30;9(7):828. doi: 10.3390/healthcare9070828. DOI: https://doi.org/10.3390/healthcare9070828

Wood SN, Milkovich R, Thiongo M, Byrne ME, Devoto B, Wamue-Ngare G, Decker MR, Gichangi P. Product-access challenges to menstrual health throughout the COVID-19 pandemic among a cohort of adolescent girls and young women in Nairobi, Kenya. EClinicalMedicine. 2022 Jul;49: 101482. doi: 10.1016/j.eclinm.2022.101482. DOI: https://doi.org/10.1016/j.eclinm.2022.101482

Patel K, Panda N, Sahoo KC, Saxena S, Chouhan NS, Singh P, et al. A systematic review of menstrual hygiene management (MHM) during humanitarian crises and/or emergencies in low- and middle-income countries. Front Public Health. 2022 Sep 28;10:1018092. doi: 10.3389/fpubh.2022.1018092. DOI: https://doi.org/10.3389/fpubh.2022.1018092

Psaki S, Haberland N, Mensch B, Woyczynski L, Chuang E. Policies and interventions to remove gender-related barriers to girls’ school participation and learning in low- and middle-income countries: a systematic review of the evidence. Campbell Syst Rev. 2022 Jan 19;18(1):e1207. doi:10.1002/cl2.1207. DOI: https://doi.org/10.1002/cl2.1207

Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021 Mar 29;372:n71. doi: 10.1136/bmj.n71. DOI: https://doi.org/10.1136/bmj.n71

Ouzzani M, Hammady H, Fedorowicz Z, Elmagarmid A. Rayyan-a web and mobile app for systematic reviews. Syst Rev. 2016 Dec 5;5(1):210. doi: 10.1186/s13643-016-0384-4. DOI: https://doi.org/10.1186/s13643-016-0384-4

Higgins JPT, Thomas J, Chandler J, Cumpston M, Li T, Page MJ, et al. Cochrane handbook for systematic reviews of interventions version 6.3. [Internet]. Cochrane; 2022. Available from: www.training.cochrane.org/handbook

Schünemann HJ, Higgins JPT, Vist GE, Glasziou P, Akl EA, Skoetz N, Guyatt GH et al. Chapter 14: Completing ‘summary of findings’ tables and grading the certainty of the evidence. Cochrane handbook for systematic reviews of interventions version 6.3 [Internet]. Cochrane; 2022. Available from: www.training.cochrane.org/handbook

Austrian K, Kangwana B, Muthengi E, Soler-Hampejsek E. Effects of sanitary pad distribution and reproductive health education on upper primary school attendance and reproductive health knowledge and attitudes in Kenya: a cluster randomized controlled trial. Reprod Health. 2021 Aug 31;18(1):179. doi: 10.1186/s12978-021-01223-7. DOI: https://doi.org/10.1186/s12978-021-01223-7

Jarrahi R, Golmakani N, Mazloom SR, Forouzanfar H. The effect of menstrual health education adopting the peer education method with the participation of mothers on adolescents’ menstrual health behaviors: a clinical trial. J Midwifery Reprod Health. 2021 Jan 1;9(1):2582-9. doi: 10.22038/jmrh.2020.42482.1489.

Min J, Ahn S. Effects of menstrual self-management education program on knowledge and behavior of menstrual self-management in high school girls. Korean J Women Health Nurs. 2018 Sep;24(3):310-21. doi: 10.4069/kjwhn.2018.24.3.310. DOI: https://doi.org/10.4069/kjwhn.2018.24.3.310

Fazio JC, Irving M, Marquez F, Deissinger M, Tomedi A, Schmitt C. The effect of sanitary pads and menstrual symptom management on school performance of adolescent girls in rural Kenya: a cluster randomized trial. Ann Glob Health. 2017 Feb;83(1):100. doi: 10.1016/j.aogh.2017.03.222. DOI: https://doi.org/10.1016/j.aogh.2017.03.222

Montgomery P, Hennegan J, Dolan C, Wu M, Steinfield L, Scott L. Menstruation and the cycle of poverty: a cluster quasi-randomised control trial of sanitary pad and puberty education provision in Uganda. PLoS One. 2016 Dec 21; 11(12):e0166122. doi: 10.1371/journal.pone.0166122. DOI: https://doi.org/10.1371/journal.pone.0166122

Phillips-Howard PA, Nyothach E, Ter Kuile FO, Omoto J, Wang D, Zeh C, et al. Menstrual cups and sanitary pads to reduce school attrition, and sexually transmitted and reproductive tract infections: a cluster randomised controlled feasibility study in rural Western Kenya. BMJ Open. 2016 Nov 23; 6(11):e013229. doi: 10.1136/bmjopen-2016-013229. DOI: https://doi.org/10.1136/bmjopen-2016-013229

Djalalinia S, Tehrani FR, Afzali HM, Hejazi F, Peykari N. Parents or school health trainers, which of them is appropriate for menstrual health education? Int J Prev Med. 2012 Sep;3(9):622-7.

Wilson E, Reeve J, Pitt A. Education. Period. Developing an acceptable and replicable menstrual hygiene intervention. Dev Pract. 2014 Apr 22; 24(1):63-80. doi: 10.1080/09614524.2014.867305. DOI: https://doi.org/10.1080/09614524.2014.867305

Oster E, Thornton R. Menstruation, sanitary products, and school attendance: evidence from a randomized evaluation. AEJ: Applied Economics. 2011 Jan;3(1):91-100. doi: 10.1257/app.3.1.91. DOI: https://doi.org/10.1257/app.3.1.91

Fetohy EM. Impact of a health education program for secondary school Saudi girls about menstruation in Riyadh city. J Egypt Public Health Assoc. 2007;82(1-2):105-26.

Jarrahi R, Golmakani N, Mazlom SR. Comparison of small group-based education with maternal participation and routine education on adolescent girls’ menstrual health behaviors, a clinical trial Reihaneh. JHAYAT. 2020 May 10;26(1):15-27.

Wilson EF, Reeve JMK, Pitt AH, Sully BG, Julious SA. INSPIRES: Investigating a reusable sanitary pad intervention in a rural educational setting - evaluating the acceptability and short term effect of teaching Kenyan school girls to make reusable sanitary towels on absenteeism and other daily activities: a partial preference parallel group, cluster randomised control trial. ScHARR Report Series [Internet]. 2012 Mar 21; 27. School of Health and Related Research , University of Sheffield. Available from: https://eprints.whiterose.ac.uk/43906/

Zulaika G, Kwaro D, Nyothach E, Wang D, Zielinski-Gutierrez E, Mason L, et al. Menstrual cups and cash transfer to reduce sexual and reproductive harm and school dropout in adolescent schoolgirls: study protocol of a cluster-randomised controlled trial in western Kenya. BMC Public Health. 2019 Oct 21;19(1):1317. doi: 10.1186/s12889019-7594-3. DOI: https://doi.org/10.1186/s12889-019-7594-3

Weiss H. Menstrual health interventions to improve education and health outcomes among Ugandan students. ISRCTN4546 1276 [Internet]. 2021. Available from: https://www.isrctn.com/ISRCTN45461276 DOI: https://doi.org/10.1186/ISRCTN45461276

Kansiime C, Hytti L, Nelson KA, Torondel B, Francis SC, Tanton C, et al. Menstrual health interventions, schooling, and mental health problems among Ugandan students (MENISCUS): study protocol for a school-based cluster-randomised trial. Trials. 2022 Sep 7;23(1):759. doi: 10.1186/s13063-022-06672-4. DOI: https://doi.org/10.1186/s13063-022-06672-4

Czerwinski BS. Variation in feminine hygiene practices as a function of age. J Obstet Gynecol Neonatal Nurs. 2000 Nov-Dec;29(6):625-33. doi: 10.1111/j.1552-6909.2000.tb02076.x. DOI: https://doi.org/10.1111/j.1552-6909.2000.tb02076.x

Loh DA, Moy FM, Zaharan NL, Mohamed Z. Disparities in health-related quality of life among healthy adolescents in a developing country - the impact of gender, ethnicity, socio-economic status and weight status. Child Care Health Dev. 2015 Nov;41(6):1216-26. doi: 10.1111/cch.12252. DOI: https://doi.org/10.1111/cch.12252

Meade T, Dowswell E. Adolescents’ health-related quality of life (HRQoL) changes over time: a three year longitudinal study. Health Qual Life Outcomes. 2016 Jan 25;14:14. doi: 10.1186/s12955-016-0415-9. DOI: https://doi.org/10.1186/s12955-016-0415-9

Yu M, Han K, Nam GE. The association between mental health problems and menstrual cycle irregularity among adolescent Korean girls. J Affect Disord. 2017 Mar 1;210: 43-8. doi: 10.1016/j.jad.2016.11.036. DOI: https://doi.org/10.1016/j.jad.2016.11.036

Shimamoto K, Hirano M, Wada-Hiraike O, Goto R, Osuga Y. Examining the association between menstrual symptoms and health-related quality of life among working women in Japan using the EQ-5D. BMC Womens Health. 2021 Sep 7;21(1):325. doi: 10.1186/s12905-021-014 62-7. DOI: https://doi.org/10.1186/s12905-021-01462-7

Shah V, Nabwera H, Sonko B, Bajo F, Faal F, Saidykhan M, et al. Effects of menstrual health and hygiene on school absenteeism and drop-out among adolescent girls in rural Gambia. Int J Environ Res Public Health. 2022;19(6): 3337. doi: 10.3390/ijerph19063337. DOI: https://doi.org/10.3390/ijerph19063337

Alam MU, Sultana F, Hunter EC, Winch PJ, Unicomb L, Sarker S, et al. Evaluation of a menstrual hygiene intervention in urban and rural schools in Bangladesh: a pilot study. BMC Public Health. 2022 Jun 2;22(1):1100. doi: 10.1186/s12889-022-13478-1. DOI: https://doi.org/10.1186/s12889-022-13478-1

Evans RL, Harris B, Onuegbu C, Griffiths F. Systematic review of educational interventions to improve the menstrual health of young adolescent girls. BMJ Open. 2022 Jun 8;12(6):e057204. doi: 10.1136/bmjopen-2021-057204. DOI: https://doi.org/10.1136/bmjopen-2021-057204

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Published

2024-03-21

How to Cite

1.
Hamada H, Ninohei M, Yamaji N, Ota E. Effects of Interventions for Menstrual Health and Hygiene Management for Adolescent Girls: A Systematic Review and Meta-analysis. PRIJNR [Internet]. 2024 Mar. 21 [cited 2024 May 23];28(2):356-7. Available from: https://he02.tci-thaijo.org/index.php/PRIJNR/article/view/265202